Lawyer and political commentator Willis Otieno has raised concerns over the Social Health Authority (SHA), criticising its contribution model as lacking transparency and failing to adhere to the basic principles of risk pooling that define legitimate insurance systems.

In a statement on Tuesday, July 15, 2025,  Otieno argued that in any genuine insurance model, risk must be pooled in a way that protects the vulnerable and distributes the burden fairly.

“In any legitimate insurance model, risk is pooled. The healthy subsidise the sick, the young subsidise the old, not through coercion, but through well-structured, actuarially sound systems that spread risk across contributors,” he said.

Further, he stated the SHA has a deeply inequitable system that punishes the poor and working-class equally with the wealthy.

“SHA is failing here. It demands flat contributions without any risk-based adjustment, without income sensitivity, and with no transparency on how risk is being pooled. Instead, it punishes the poor and working class equally with the wealthy a total distortion of insurance logic,” he added.

KNH

This comes a day after Kenyatta National Hospital (KNH) issued new guidelines for patients seeking admission under the SHA.

In a notice on July 9, 2025,  the facility warned that SHA will not cover any inpatient costs if the admission was not properly referenced at the time of entry.

Before seeking care, patients must present a valid national identification card that is registered under SHA and linked to an active membership without which, admission under the new health scheme will not be accepted.

Patients are also required to obtain a reference number from SHA, accompanied by a confirmation message indicating that the visit has been successfully initiated in the SHA system.

Additionally, patients are advised to confirm that their Social Health Insurance Fund (SHIF) status is active.

If the SHIF account is inactive, the hospital has directed patients to return to the Health Information Desk for a new reference number once activation is complete.

“If your SHIF is inactive at the time of admission, activate it immediately, return to the Health Information Desk to get a new reference number. This will allow you to benefit from the SHA cover starting date when it’s issued,” the notice reads in part.

The move is part of KNH’s ongoing implementation of SHA protocols to ensure Universal Health Coverage (UHC) for all Kenyans.